Clobetasol Propionate is indicated in: Initial control of all forms of hyperacute eczema in all age groups Chronic hyperkeratotic eczema of the hands and feet and patches of chronic lichen simplex Chronic hyperkeratotic psoriasis of any area of the body Severe acute photosensitivity Hypertrophic lichen planus Localized bullous disorders Keloid scarring Pretibial myxoedema Vitiligo Suppression of reaction after cryotherapy Scalp Solution is indicated in the topical therapy of recalcitrant corticosteroid-responsive dermatoses of the scalp, including recalcitrant cases of psoriasis and seborrheic dermatitis.
Clobetasol / Clobetasone & Combined Preparations
Clobetasol Propionate is a very potent topical corticosteroid. It has anti-inflammatory, antipruritic and vasoconstrictive properties. It shows anti-inflammatory activity via multiple mechanisms to inhibit late phase allergic reactions. It decreases the density of mast cells, chemotaxis and activation of eosinophils. It also reduces cytokine production and inhibits the metabolism of arachidonic acid.
Like other topical corticosteroids, clobetasol propionate has anti-inflammatory, antipruritic and vasoconstrictive properties. The mechanism of the anti-inflammatory activity of the topical steroids, in general, is unclear. However, corticosteroids are thought to act by induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor, arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Topical cream/ ointment: Clobetasol should be applied with gentle rubbing to the affected skin areas twice daily. Dosage should not normally exceed 50 gm/ week and the duration of a course should not be more than 4 weeks. The potency can further enhanced by the use of occlusive dressing. Scalp Solution: Apply required quantity of spray of Clobetasol Scalp Solution once or twice daily to the affected areas of the scalp and gently rub in. The total dose applied should not exceed 50 ml weekly. If necessary, Clobetasol Scalp Solution may be massaged into the scalp using the tips of the fingers. Therapy should be discontinued if no response is noted after one week or as soon as the lesion heals. It is advisable to use Clobetasol Scalp Solution for brief periods only.
Co-administered drugs that can inhibit CYP3A4 (eg ritonavir, itraconazole) have been shown to inhibit the metabolism of corticosteroids leading to increased systemic exposure.
Contraindicated in Cutaneous infections such as impetigo, tinea corporis and herpes simplex, Infestations such as scabies, Acne vulgaris, Hypersensitivity, Rosacea, Gravitational ulceration, Perioral dermatitis, Children under 1 year. Avoid long-term therapy particularly in children, in whom adrenal suppression occurs readily. If Clobetasol is required for use in children, it is recommended that the treatment should be weekly reviewed. Avoid prolonged application to face because the face than other area of the body exhibits more atrophic changes with potent corticosteroids. Discontinue the use if there is spread of infection. Avoid contact with eyes.
Generally this preparation is well tolerated. However, few side effects after prolonged and intensive treatment may cause local atrophic changes in the skin such as thinning, striae, and dilatation of the superficial blood vessels, particularly when occlusive dressings are used, or when skin folds are involved.
Clobetasol should be avoided in pregnant women, Mothers using large amounts of the drug should be aware of potential excretion in milk.
Acute overdosage is very unlikely to occur, however, in the case of chronic over-dosage or misuse the features of hypercortisolism may occur and in this situation topical steroid should be discontinued.
Keep below 30°C temperature, protected from light and moisture. Do not freeze. Keep out of the reach of children.
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